PMID- 31875204
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220413
IS  - 2474-7661 (Electronic)
IS  - 2474-7661 (Linking)
VI  - 3
IP  - 11
DP  - 2019 Nov
TI  - Achieving Validated Thresholds for Clinically Meaningful Change on the Knee 
      Injury and Osteoarthritis Outcome Score After Total Knee Arthroplasty: Findings 
      From a University-based Orthopaedic Tertiary Care Safety Net Practice.
PG  - e00142
LID - 10.5435/JAAOSGlobal-D-19-00142 [doi]
LID - e00142
AB  - A lack of knowledge exists about which patient characteristics predict failure to 
      meet validated thresholds for clinically meaningful change on the Knee Injury and 
      Osteoarthritis Outcome Score (KOOS) after total knee arthroplasty (TKA). METHODS: 
      A retrospective chart review was performed on patients who underwent primary TKA 
      by a single surgeon between January 2013 and June 2018. Variables included 
      demographics (age, sex, race, and insurance type), comorbidities, body mass 
      index, and preoperative KOOS subscale scores. Multivariate logistic regression 
      was performed to identify characteristics associated with failing to meet or 
      exceed the minimal clinically important difference (MCID) and substantial 
      clinical benefit (SCB) on each KOOS subscale 6 months after TKA. RESULTS: A total 
      of 159 patients were included. At 6 months after TKA, approximately one-third of 
      patients (21% to 32%) failed to meet or exceed the MCID and 27% to 39% failed to 
      meet or exceed the SCB on all KOOS subscales. Better preoperative KOOS Symptoms, 
      quality of life, and activities of daily living subscale scores were 
      statistically significantly associated with failing to meet the MCID and SCB on 
      each respective subscale. Demographics, comorbidities, and body mass index were 
      not notable predictors of either outcome for any of the KOOS subscales. 
      DISCUSSION: About one-third of TKA patients in this single-site, single-surgeon 
      sample failed to achieve a clinically meaningful outcome, and up to 4 in 10 
      patients had a less-than-ideal outcome 6 months after surgery. Surgeons should 
      take care to set realistic expectations for patients with the least severe knee 
      problems before TKA because this subgroup is especially at a high risk of failing 
      to achieve a satisfactory outcome.
CI  - Copyright (c) 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf 
      of the American Academy of Orthopaedic Surgeons.
FAU - Haydel, Adam
AU  - Haydel A
AD  - LSUHSC School of Medicine (Mr. Haydel and Mr. Guilbeau); the Department of 
      Orthopaedics (Dr. Roubion and Dr. Dasa), LSUHSC School of Medicine; the LSUHSC 
      School of Public Health (Dr. Leonardi), New Orleans, LA; and the BioMedEcon, Moss 
      Beach, CA (Dr. Bronstone).
FAU - Guilbeau, Seth
AU  - Guilbeau S
AD  - LSUHSC School of Medicine (Mr. Haydel and Mr. Guilbeau); the Department of 
      Orthopaedics (Dr. Roubion and Dr. Dasa), LSUHSC School of Medicine; the LSUHSC 
      School of Public Health (Dr. Leonardi), New Orleans, LA; and the BioMedEcon, Moss 
      Beach, CA (Dr. Bronstone).
FAU - Roubion, Ryan
AU  - Roubion R
AD  - LSUHSC School of Medicine (Mr. Haydel and Mr. Guilbeau); the Department of 
      Orthopaedics (Dr. Roubion and Dr. Dasa), LSUHSC School of Medicine; the LSUHSC 
      School of Public Health (Dr. Leonardi), New Orleans, LA; and the BioMedEcon, Moss 
      Beach, CA (Dr. Bronstone).
FAU - Leonardi, Claudia
AU  - Leonardi C
AD  - LSUHSC School of Medicine (Mr. Haydel and Mr. Guilbeau); the Department of 
      Orthopaedics (Dr. Roubion and Dr. Dasa), LSUHSC School of Medicine; the LSUHSC 
      School of Public Health (Dr. Leonardi), New Orleans, LA; and the BioMedEcon, Moss 
      Beach, CA (Dr. Bronstone).
FAU - Bronstone, Amy
AU  - Bronstone A
AD  - LSUHSC School of Medicine (Mr. Haydel and Mr. Guilbeau); the Department of 
      Orthopaedics (Dr. Roubion and Dr. Dasa), LSUHSC School of Medicine; the LSUHSC 
      School of Public Health (Dr. Leonardi), New Orleans, LA; and the BioMedEcon, Moss 
      Beach, CA (Dr. Bronstone).
FAU - Dasa, Vinod
AU  - Dasa V
AD  - LSUHSC School of Medicine (Mr. Haydel and Mr. Guilbeau); the Department of 
      Orthopaedics (Dr. Roubion and Dr. Dasa), LSUHSC School of Medicine; the LSUHSC 
      School of Public Health (Dr. Leonardi), New Orleans, LA; and the BioMedEcon, Moss 
      Beach, CA (Dr. Bronstone).
LA  - eng
PT  - Journal Article
DEP - 20191104
PL  - United States
TA  - J Am Acad Orthop Surg Glob Res Rev
JT  - Journal of the American Academy of Orthopaedic Surgeons. Global research & 
      reviews
JID - 101724868
PMC - PMC6903813
EDAT- 2019/12/26 06:00
MHDA- 2019/12/26 06:01
PMCR- 2019/11/04
CRDT- 2019/12/26 06:00
PHST- 2019/12/26 06:00 [entrez]
PHST- 2019/12/26 06:00 [pubmed]
PHST- 2019/12/26 06:01 [medline]
PHST- 2019/11/04 00:00 [pmc-release]
AID - JAAOSGlobal-D-19-00142 [pii]
AID - 10.5435/JAAOSGlobal-D-19-00142 [doi]
PST - epublish
SO  - J Am Acad Orthop Surg Glob Res Rev. 2019 Nov 4;3(11):e00142. doi: 
      10.5435/JAAOSGlobal-D-19-00142. eCollection 2019 Nov.